Reflective Writing in Nursing Education

This assignment delves into the significance of reflective writing within nursing education. It examines various research studies that highlight the influence of reflective practices on nursing students' learning, professional development, and overall competence. The analysis encompasses diverse perspectives on how reflective journals and other techniques contribute to enhancing student understanding of complex clinical scenarios and fostering critical thinking skills.

Nursing

Table of Contents
INTRODUCTION...........................................................................................................................1
DESCRIPTION ...............................................................................................................................2
FEELING.........................................................................................................................................3
ANALYSIS......................................................................................................................................1
PEER GROUP ASSESSMENT.......................................................................................................3
CONCLUSION................................................................................................................................3
ACTION PLAN...............................................................................................................................4
REFERENCES................................................................................................................................5

INTRODUCTION
In nursing, it is important to provide treatment to services user accordance to their needs,
so that they can easily recover from health issues. There are different incidents took place at the
time of providing services to patient. The present essay will reflect the situation which took place
at the time of treating old lady. In this report discussion will be done on the negative and positive
aspects which was taken place at the time of providing treatment to the 75-year-old lady. Further
professional value which was implemented in respect to provide safe and effective care is also
discussed. Along with this, on the basis of my learning I will analyze and draw learning outcome
of my work. At the end of the essay I will explain what I learned and my experience and the
changes which I will make in my future practices.
Furthermore, examples will be provided of the situation where professionalism, NHS
values 6C's and ethical consideration will be include in practices. Importance of the NHS
Constitution and NHS values incorporated 6C's that is (competence, communication, courage,
commitment and care) underpins ethics will also investigate. Knowledge and my understanding
regarding the professional nature of nursing will also reflected. All the personal information of
my patient will be kept confidentially. Therefore, Eliza name will be used for referring the
patient. This essay will reflect the code of professional conduct (2015) and the core component
of national midwifery council. According to this code of conduct it is necessary for nurse and
health care professional to treat the patient legally and ethically and make sure the wellbeing of
services user. All the patient should be treated in well manner without making any type of
discrimination. Apart from this discussion will be done on the way I used to involve with patient
and make relationship with them with the use of my interpersonal skill. Along with this, I will
take feedback from my seniors so that improvement can be made on the basis of feedback. At
last action plan will be outlined and then conclusion will be drawn on the basis of action plan.
There are various models of reflection which can be utilizes by professional for
evaluating experience. Different type of reflective model permits medical professional to develop
their existing knowledge and enhancing their learning (Okamoto and et.al., 2017). This can be
done through learning from mistake they have done in the past. Further it is suggested that Gibbs
model of reflection is known as the formal reflection which follows number of specific steps for
becoming successful. It is effective model of reflection which reflect what is going positively
1

and negatively at the time of practicing in health care. There are 6 stages in Gibbs reflective
cycle which are discussed below:
DESCRIPTION
During placement, I witnessed both positive and negative symptoms. It was the second
year of my placement and I was working under the supervisor. Eliza was a 75-year-old lady who
was suffering from mental illness and she also has dementia, aggression and short-term memory
loss problem. Eliza was facing difficulty because she was experiencing the symptoms such as
delusions and hallucinations. According to the Mental act she was required to be admitted in the
hospital so that treatment can be provided to her on right time. It became vital to admit her so
that other people do not get harm by her actions because of her mental problem (Flower and
et.al., 2016). Further, she was suffering from mental health problem so she was admitted into
psychiatric ward where treatment was provided to her under supervision of different health care
professionals.
At the time of admitting Eliza it has been noticed that she refused to take treatment from
the nurses. She was also facing problems since last one year because of her venous leg ulcers in
her left leg because she refused to take treatment. She had not taken treatment and precaution
due to this reason her wound got infected and she was unable to make any movement in leg.
After admitting, her wound was assessed by me and my supervisor. Me and my mentor provided
her treatment and it was painful but effective in recovering infection. At the ward round the
doctor wanted to reassess Eliza’s wound and he suggested that old dressing need to be removed
because patient was suffering from pain. Further Health care professional suggested that wound
should be regularly reviewed and treated well (Tesh and Kautz, 2017). My mentor suggested me
to spend time with Eliza and communicate with her which could help in making good
relationship with her. I explained the old lady what was happening with her and why she was
closely supervised by doctors. I observed her facial expressions which showed that she was quite
uncomfortable and depressed. For making her comfortable I made her informed about treatment
which she will receive and the process of her wound healing. Further, I also told her, importance
of medication, nursing and intervention. It is important to communicate all these things to the
patient so that she does not get depressed or refuse from taking treatment (Lin, and et.al., 2016).
It is also my responsibility to listen to the patient and respond to their queries. Through strong
communication I made good relations with Eliza so she requested me to do her dressing instead
2

of my supervisor. Although I do not have much experience of dressing so I was not sure that I
could do it properly or not. I only have theoretical knowledge and not practical one because in
simulation classes I practiced only for bandaging and cleaning. While at the time of dressing I
was unable to remove her bandage because it got stuck with skin due to this issue she was in
pain. Hence, after dressing she was provided with antibiotics so that the damaged area can be
protected from getting infected by germs again (Cronin and Lowes, 2016). For reducing her pain
Eliza was prescribed paracetamol tablet.
At the time of providing treatment to Eliza one of the other health care assistant
interrupted through stating that I should use forceps for removing the wound because it shows
professionalism. But I knew that using forceps can increase the level of pain and skin might also
get removed from below the knees. So, I used my own way of dressing which is very effective in
whole process. When dressing was completed I was so relaxed and I was overwhelmed with
what I had done in treatment. After completing the whole procedure, me and my mentor decided
to communicate with HCA about entire procedures. Providing treatment to an old lady is not an
easy task (Sethares and Asselin, 2017). It is so because old lady was not comfortable and she was
refusing to take treatment which created problem. Eliza was 75-year-old, which creates more
problem because her skin was removed from below the knees due to which she is facing lots of
pain.
FEELING
At the time treating to the patient I was very much uncomfortable because it was the first
time I was doing dressing to an old lady and I have only theoretical knowledge of it. Further
presence of healthcare assistant and my mentor also made me feel nervous. Along with this
bandage got stuck with skin and Eliza was in pain but still she was not showing her pain.
Interrupting health care professional; made me confused that I should use forceps or not at the
time of dressing. I was unable to decide but my mentor suggested me avoid using forceps and
carry on with my own process. I know that HCA have more knowledge of it but I know that
using forceps can increase the pain level of Eliza. By seeing pain on her face might create
difficulty for me but using by interpersonal skill and I treated her infected area wound smoothly.
For reducing her pain, I diverted her mind by communicating with her on different topic (Gibbs'
Reflective Cycle 2017). Along with this I stopped dressing when she was unable to tolerate the
pain so that she can get relaxed and make her more comfortable. Providing treatment to Eliza is
3

one of my great achievement. I understood that at the time of providing treatment to patient it is
important to keep speaking with them and ask them such type of question which can divert their
mind from the pain. Along with this, I can state that support which I got from my mentor made
me feel happy and comfortable. Feedback given by old lady on providing her treatment made me
feel proud. Further I also noticed that effective communication is very important in health and
social care organization and for nursing it is effective in providing treatment. After completing
the entire dressing process, I felt emotionally distressed because I can treat Eliza with more
comfort instead of making her suffer from pain. Eliza was my first patient to whom I provided
treatment and I will never forget her. It is so because I started providing care to her from the first
day she was admitted in hospital.
I took feedback from my mentor regarding my way of providing treatment. He gave
positive feedback to me regarding my work which made me feel happy and satisfied. This also
motivated me towards my work. While health care assistant told me to use forceps and I not
listened to hem so I felt quite sad because he was senior and it is my responsibility to listen him
and follow his instructions. But my supervisor told me to provide treatment to Eliza by my own
method which make me confused. Hence, I decide to carry the process in my own way and it was
successful.
Evaluation
According to my view, I felt that my performance was appropriate and everything went
well. The whole treatment which was provided to Eliza was one of the important tasks for me in
respect to develop various skills. From this I got enough knowledge regarding dressing of
wound. The health care organization for which, I was working as a student nurse ,it was my
responsibility to provide care to the patient as it was my first concern to treat services user in
right manner. Further it is also important that patient’s dignity, belief and religious aspects
should not be get impacted because of my carelessness (Okamoto and et.al., 2017). With the help
of supervisor I easily performed my work effectively and made sure that all the information
provided by Eliza is kept confidential. This entire treatment procedure motivated me and I
understood thst I have enough knowledge of providing treatment to patient. I also understood
the importance of communication in health and social care sector. Further I regret that I will not
challenge the healthcare assistant who interrupted me at the time of treating patient. However, I
told health care assistant that using forceps only for making it look professionalism is not right
4

way of providing treatment. It is important that treatment should be provided from which patient
do not suffer from higher pain. I used to speak in an appropriate manner so that health care
assistant understood it and not warned not to repeat such kind of mistake in future As per the
code of conduct it is a responsibility of every healthcare professional to ensure that their action
do not harm patients.
Health care assistant should respond in a right manner and state that he will not repeat
this mistake in future. Further I also noticed changes in his practices which he provided to
different type of patient. From this I learned the importance of positive interaction with
colleagues. This was one of the best experience for me and I will not forget each and everything
which I learned at the time of treating another patient. Further I was unable to make good
relation with health care assistant because I was totally depended on my supervisor. Before
leaving, I communicated with healthcare professional after completing the treatment of an old
lady because I do not listen to him at the time of treating Eliza. My different skills were also
developed such as communication skill, listening skill, interpersonal skill and other skills which
are needed in respect to provide treatment to patient at health and social care organization
(Flower and et.al., 2016). There are many positive outcomes which is gained from this
experience. Further I also developed by knowledge regarding the way infected area can be
treated without any risk of infections. I learned the way to make patient conformable so that she
can take treatment from me without feeling uncomfortable and completely believe me on at the
time of taking treatment. I learned that if all health care professional work in a team then it will
be very effective in respect to treat patient in an effective manner. However, the incident was
challenging for me because I had never before practiced it and it was first time I was treating to
the patient. I understood that in at the time of treating patient it is important to make good
relation with them so that I can know their choice regarding taking treatment. Further, providing
treatment according to the choice of services user is very effective in respect to make patient
comfortable. Further I understood that I need to learn more from my seniors in respect to become
one of the best health care professional. However, it was the first time I was providing treatment
which was successful but it is not necessary that in future using my own method to provide
treatment may be right. Therefore, it is important for me to learn so from different healthcare
professional and listen from them so that I can provide treatment in more effective manner to the
patient (Cronin and Lowes, 2016.). Further different types of patient who may not support health
5

care professional at the time of taking treatment so at that time difficulty can be faced by me.
Support from patient is also important in respect to provide services in an effective manner.
6

ANALYSIS
During the analysis, I was able to develop some very crucial and clinical practices which
are very essential in evaluating the incidents happened with Eliza. I was having very less
knowledge in context with addressing those patients who are suffering from aggression, mental
illness or some short term memory loss problems (Davis, Taylor and Reyes, 2014). I must work
in suitable learning environment to improve my performance and practices. Short term memory
loss, sometimes can create high problems because this illness is very complicated and proper
training is compulsory while dealing with those patients who are suffering from these types of
problems.
All the practices should be performed very ethically, therefore all the nurses must have
the complete knowledge and understanding of skills to perform those activities. Aggressive
patients will not be having any kind of risk; therefore, I have decided to get a valid competency
in dementia and aggression. At the time of learning, the assessment done by me was using the
Waterlow scale as it was easy for me to identify different types of mental illness and short term
memory problems. Thus, it was helpful for me in understanding the most effective treatment for
each particular illness. The material used in curing these illnesses can not be compromised, as
these must be having the highest quality.
According to the report published by NHS in 2016, it was clearly mentioned that there
have been some serious improvements in healing methods and approaches when I compared this
to past. The material was not properly available so there was very less understanding of how to
treat those patients suffering from dementia, aggression or mental illness (Tham and Lynch,
2014). The final objective was to ensure that the patient will become fully fit. The practices
which I prepared for Eliza was totally accurate. There were some improvements required and
nursing team helped me out in doing that. Through this whole preparation, I have learned a lot.
The guidance of the entire team was very helpful for me in knowing that how much I have
learned through all this.
My major strength was to prepare a plan for those patients who are suffering from mental
illness and the practices used for curing is made after I have discussed it with my mentor. The
aim was to promote the curing practices used in dementia, aggression and short-term memory.
Medication and psychotherapy are the best practices used to cure the patients suffering from
aggression or mental illness (Bunkenborg and et.al., 2013). It is very easy to use and cost

effective as well. Before starting any treatment, I have discussed it with my mentor and finalized
the best therapy for Eliza. I was closely monitored by my mentor just in case if I made any
mistake while carrying out the treatment and fortunately all went smoothly.
2

The treatment is different for those patients who are heavily suffering from these
diseases. Some community support programs are also recommended reducing the effects of
mental illness and aggression. All these were relatively new to me but I was very actively
involved in all of this. I have used all my verbal and nonverbal communication skills, so that I
will remain connected with the patients and maintain a healthy relationship with them (Akhtar-
Danesh and et.al., 2013). This type of relationship will develop a trust level among each other
and it also helps in increasing the confidence and self-esteem of the Eliza. Therapeutic
communication was developed so that the patient will be able to function more properly. The
major weakness of mine was too much reliance on my mentor. But now I am having enough
confidence of treating the patients who are suffering from mental illness, dementia or short-term
memory loss (Lestander, Lehto and Engström, 2016).
PEER GROUP ASSESSMENT
It includes all the students who are having the responsibilities of assessing their own
work in context with the set criteria. My group helped me a lot while learning. Most importantly
during the time when I was communicating very efficiently and effectively. Proper
communication is very essential in sharing the valuable ideas and actively listening the opinions
and views of others, so that it will be beneficial for me to give suggestion regarding the healing
practices.
CONCLUSION
From this discussion, it has been concluded that this reflection was very essential while
analyzing the skills used by me during the entire process of treating Eliza. In my opinion, the
Gibbs reflective stages of curing the patients was well achieved. This particular reflection was a
learning experience because it helped me in improving my treatment skills and also increased my
confidence in fulfilling the competencies, which was based on all the positive changes I have
achieved. The staff who was involved with Eliza, the 75 years old lady could have easily
prevented the effects of mental illness, if they had utilized their skills and knowledge.
Nurses are the ones who are working with the patients suffering from short term memory
loss and mental illnesses. This reflection helped me in understanding the importance of close
observations. The staff have used meditation as the curing practices, the same I was taught
3

during my education. But in my opinion, I will do the treatment in the same way I used to do
when I started treating the patients. All these learnings taught me that during the treatment, I
should not get distracted or divert my mind or get nervous. Further, I have realized that I need
more confidence so that I will be able to challenge my colleagues. The first and the most
important thing was to get the patient fully fit. I also need to support my colleagues, because the
working pressure is too much and we have to make sure that the patients are not under any risk.
It can be stated that through providing treatment I gain lots of knowledge related to the dressing
the wound and it is one of the great experiences for me in respect to learn new things and
develop different skills.
ACTION PLAN
This was the best experience as it motivates me to pursue some more learning activities. I
have to grab all the opportunities and must be assertive so that I will give all and try my best to
improve my skills and professional development. From this reflection, I have gained lots of
experience, but in near future I have to keep myself up to date with all the new practices used for
treating the patients who are suffering from short term memory loss or mental illness. I will share
all my experience with my peers because it is the basic and fundamental part of nursing care.
4

REFERENCES
Books and Journals
Akhtar-Danesh, N. and et.al., 2013. Perceptions of professionalism among nursing faculty and
nursing students. Western journal of nursing research. 35(2). pp.248-271.
Bassot, B., 2016. The reflective journal. Palgrave Macmillan.
Bunkenborg, G. and et.al., 2013. Impact of professionalism in nursing on in‐hospital bedside
monitoring practice. Journal of advanced nursing. 69(7). pp.1466-1477.
Cronin, C.J. and Lowes, J., 2016. Embedding experiential learning in HE sports coaching
courses: an action research study. Journal of Hospitality, Leisure, Sport & Tourism
Education. 18. pp.1-8.
Davis, L., Taylor, H. and Reyes, H., 2014. Lifelong learning in nursing: A Delphi study. Nurse
education today. 34(3). pp.441-445.
Flower, A. and et.al., 2016. Applying the principles of the Five Phase (Wu Xing) model to
inform good practice for studies of Chinese herbal medicine. European Journal of
Integrative Medicine. 8(3). pp.191-197.
Lestander, Ö., Lehto, N. and Engstrom, Å., 2016. Nursing students' perceptions of learning after
high fidelity simulation: Effects of a Three-step Post-Simulation Reflection Model. Nurse
education today. 40. pp.219-224.
Lin, C. W. and et.al., 2016. A word-count approach to analyse linguistic patterns in the reflective
writings of medical students. Medical education online. 21(1). p.29522.
Okamoto, R. and et.al., 2017. Realities of Reflective Practice Skill among Public Health Nurses
in Japan and Related Learning and Lifestyle Factors. Open Journal of Nursing. 7(05).
p.513.
Sethares, K. A. and Asselin, M. E., 2017. The effect of guided reflection on heart failure self-
care maintenance and management: A mixed methods study. Heart & Lung: The Journal
of Acute and Critical Care. 46(3). pp.192-198.
Tesh, A. S. and Kautz, D. D., 2017. Using Reflective Practice in a Leadership Course. Nurse
educator. 42(3). pp.117-119.

Tham, P. and Lynch, D., 2014. Prepared for practice? Graduating social work students'
reflections on their education, competence and skills. Social Work Education. 33(6). pp.704-717.
Online
Gibbs' Reflective Cycle 2017. [Online]. Available through:
<https://www.mindtools.com/pages/article/reflective-cycle.htm|>. [Accessed on 28th July 2017].